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Liu Q, Zhang T, Chen L, Zhou X, Zhang X, Zheng W, Niu S, Zhou F. Correlation of immediate prevalence of cervical precancers and cancers with HPV genotype and age in women with ASC-US/hrHPV+: a retrospective analysis of 2292 cases. J Clin Pathol 2024; 77:338-342. [PMID: 36653168 DOI: 10.1136/jcp-2022-208580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023]
Abstract
AIMS To stratify the risk of cervical precancers (high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS)) and cancers (squamous cell carcinoma (SCC) and adenocarcinoma) based on distinct high-risk human papillomavirus (hrHPV) genotypes as well as age groups among women with atypical squamous cells of undetermined significance (ASC-US) and hrHPV+results. METHODS In total, 2292 cases of ASC-US/hrHPV+ with immediate follow-up biopsy results were included in the study for prevalence analysis. RESULTS Overall, 12.2% women with ASC-US /hrHPV+ had HSIL+ while 0.22% had AIS+ lesions. The HPV-16+ group (31.6%) showed significantly higher prevalence of HSIL+ squamous lesions than other genotype groups (p<0.0001). The prevalence of SCC is significantly higher in HPV-16+ (1.8%) or HPV-18/45+ (1.1%) group than women in other genotype groups (0.1%) (p<0.0001). The HPV-18/45+ group (1.7%) showed significantly higher prevalence of AIS+ glandular lesions than other genotype groups (p=0.003). In addition, SCC prevalence was significantly higher in age over 50 group than that in age under 50 group (1.2% vs 0.2%, p=0.012). CONCLUSION Women with ASC-US/hrHPV+ are at significant risk of cervical precancers and cancers; notably, HPV-16+ group has a higher risk of HSIL squamous lesions and SCC while HPV-18/45+ group has a higher risk of AIS+ glandular lesions. In addition, the older patient group (>50 years) has a significantly higher risk of SCC. Therefore, HPV genotyping as well as patient age need to be considered in the clinical management of patient.
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Affiliation(s)
- Qin Liu
- Department of Pathology, Zhejiang University School of Medicine Women'sHospital, Hangzhou, Zhejiang, China
| | - Tao Zhang
- Department of Gynecology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Liqing Chen
- Department of Gynecology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Xin Zhou
- Department of Pathology, Zhejiang University School of Medicine Women'sHospital, Hangzhou, Zhejiang, China
| | - Xiaofei Zhang
- Department of Pathology, Zhejiang University School of Medicine Women'sHospital, Hangzhou, Zhejiang, China
| | - Wenxin Zheng
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pathology, Parkland Hospital, Dallas, Texas, USA
| | - Shuang Niu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pathology, Parkland Hospital, Dallas, Texas, USA
| | - Feng Zhou
- Department of Pathology, Zhejiang University School of Medicine Women'sHospital, Hangzhou, Zhejiang, China
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Browning L, Winter L, Cooper RA, Ghosh A, Dytor T, Colling R, Fryer E, Rittscher J, Verrill C. Impact of the transition to digital pathology in a clinical setting on histopathologists in training: experiences and perceived challenges within a UK training region. J Clin Pathol 2023; 76:712-718. [PMID: 35906044 PMCID: PMC10511979 DOI: 10.1136/jcp-2022-208416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/08/2022] [Indexed: 11/03/2022]
Abstract
AIMS With increasing utility of digital pathology (DP), it is important to consider the experiences of histopathologists in training, particularly in view of the varied access to DP across a training region and the consequent need to remain competent in reporting on glass slides (GS), which is also relevant for the Fellowship of the Royal College of Pathologists part 2 examination. Understanding the impact of DP on training is limited but could aid development of guidance to support the transition. We sought to investigate the perceptions of histopathologists in training around the introduction of DP for clinical diagnosis within a training region, and the potential training benefits and challenges. METHODS An anonymous online survey was circulated to 24 histopathologists in training within a UK training region, including a hospital which has been fully digitised since summer 2020. RESULTS 19 of 24 histopathologists in training responded (79%). The results indicate that DP offers many benefits to training, including ease of access to cases to enhance individual learning and teaching in general. Utilisation of DP for diagnosis appears variable; almost half of the (10 of 19) respondents with DP experience using it only for ancillary purposes such as measurements, reporting varying levels of confidence in using DP clinically. For those yet to undergo the transition, there was a perceived anxiety regarding digital reporting despite experience with DP in other contexts. CONCLUSIONS The survey evidences the need for provision of training and support for histopathologists in training during the transition to DP, and for consideration of their need to maintain competence and confidence with GS reporting.
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Affiliation(s)
- Lisa Browning
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Lucinda Winter
- Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Abhisek Ghosh
- Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Clinical Laboratory Sciences, University of Oxford, Oxford, UK
| | - Thomas Dytor
- Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Richard Colling
- Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Eve Fryer
- Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jens Rittscher
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Department of Engineering Science, University of Oxford, Oxford, UK
- Big Data Institute, University of Oxford, Oxford, UK
| | - Clare Verrill
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Tran C, Virine B, Gershon A, Kwan KF, Ettler HC. Characterising the use of surgical pathology rush requests: a descriptive analysis and survey. J Clin Pathol 2023; 76:64-67. [PMID: 35292442 DOI: 10.1136/jclinpath-2022-208170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/24/2022] [Indexed: 12/27/2022]
Abstract
This study aimed to characterise priority or 'rush' surgical pathology requests and identify potentially targetable factors. We performed a retrospective descriptive analysis of rush requests at our institution from 2016 to 2019 and conducted a survey asking pathologists about their perspectives on rush cases. There were 3677 rush cases, with case characteristics generally stable over the study period. Two categories of requests were identified based on hospital status; outpatient requests more frequently provided a specific date for diagnosis, while inpatient rush requests generally required a diagnosis as soon as possible. Most pathologists found rush cases to be somewhat more stressful compared with routine cases (65.2%) and found it very or extremely useful to know when a result is needed (86.9%). The use of hospitalisation status, and identifying if results are required by a certain date, may help in more effective triaging of rush surgical pathology cases.
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Affiliation(s)
- Christopher Tran
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Boris Virine
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Ariel Gershon
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Keith F Kwan
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Helen C Ettler
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
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Rakha EA, Toss M, Shiino S, Gamble P, Jaroensri R, Mermel CH, Chen PHC. Current and future applications of artificial intelligence in pathology: a clinical perspective. J Clin Pathol 2020; 74:409-414. [PMID: 32763920 DOI: 10.1136/jclinpath-2020-206908] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/07/2020] [Indexed: 12/17/2022]
Abstract
During the last decade, a dramatic rise in the development and application of artificial intelligence (AI) tools for use in pathology services has occurred. This trend is often expected to continue and reshape the field of pathology in the coming years. The deployment of computational pathology and applications of AI tools can be considered as a paradigm shift that will change pathology services, making them more efficient and capable of meeting the needs of this era of precision medicine. Despite the success of AI models, the translational process from discovery to clinical applications has been slow. The gap between self-contained research and clinical environment may be too wide and has been largely neglected. In this review, we cover the current and prospective applications of AI in pathology. We examine its applications in diagnosis and prognosis, and we offer insights for considerations that could improve clinical applicability of these tools. Then, we discuss its potential to improve workflow efficiency, and its benefits in pathologist education. Finally, we review the factors that could influence adoption in clinical practices and the associated regulatory processes.
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Affiliation(s)
- Emad A Rakha
- Histopathology, University of Nottingham School of Medicine, Nottingham, UK
| | - Michael Toss
- Histopathology, University of Nottingham School of Medicine, Nottingham, UK
| | - Sho Shiino
- Histopathology, University of Nottingham School of Medicine, Nottingham, UK
| | - Paul Gamble
- Google Health, Google, Palo Alto, California, USA
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Mehta A, Nathany S, Tripathi R, Sharma SK, Saifi M, Batra U. Non-amplification genetic alterations of HER2 gene in non-small cell lung carcinoma. J Clin Pathol 2020; 74:106-110. [PMID: 32527755 DOI: 10.1136/jclinpath-2020-206730] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 02/01/2023]
Abstract
AIMS The present study investigated the incidence and spectrum of human epidermal growth factor receptor 2 (HER2) mutations, associated clinicopathological characteristics and the co-occurrence of HER2 gene amplification in the HER2 gene mutated cases in non-small cell lung cancer (NSCLC). METHODS All patients with advanced lung adenocarcinoma (LUAD) who underwent broad genomic profiling by next generation sequencing (NGS) from 2015 to 2019 were included in the study. HER2 gene amplification was checked in all the HER2 gene mutated cases. Tumour tissues of all the mutated cases were examined by fluorescent in situ hybridisation (FISH). RESULTS Fifty-four (37.2%) out of the 145 cases harboured tier 1 driver mutations comprising EGFR in 22.1%, ALK rearrangements in 7.6% cases, ROS1 rearrangements and BRAF V600E in 3.5% cases each, and NTRK fusion in 0.7% cases. Nine (6.2%) cases exhibited a significant genetic alteration in HER2 gene (tiers 2 and 3) on NGS. The most common alteration was exon 20 insertion of amino acid sequence AYVM in five cases (p.E770_A771insAYVM) followed by insertion of YVMA (p.A771_Y772insYVMA) in one case, insGSP (p.V777_G778insGSP) in one case and two missense mutations: p.G776C and p.QA795C (novel variant). The median copy number of the HER2 gene was 3.21 while on FISH, the median HER2/CEP17 ratio was 2.0. CONCLUSIONS There is a relatively higher occurrence of HER2 exon 20 mutations as primary oncogenic driver in NSCLC especially LUAD. Our cohort has demonstrated (p.E770_A771insAYVM) as the strikingly dominant insertion mutation against the most often globally reported (p.A771_Y772insYVMA).
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Affiliation(s)
- Anurag Mehta
- Deapartment of Laboratory Medicine, Transfusion Services and Molecular Diagnostics, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Shrinidhi Nathany
- Section of Molecular Diagnostics, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Rupal Tripathi
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Sanjeev Kumar Sharma
- Section of Molecular Diagnostics, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Mumtaz Saifi
- Section of Molecular Diagnostics, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Ullas Batra
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
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